WELCOME

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We work hard to ensure that our new patients are well at ease,

because we know that visiting a doctor for the first time can be an

overwhelming and nerve wracking experience. At our office, you will be welcomed with a warm greeting, have the option to complete the paperwork in the comfort of your own home, and have a personalized conversation on strategies that will contribute to improving the quality of your life.

ONLINE FORMS

When you complete these forms ahead of time, it allows us to get right to your care.  Having insight into your health history provides us with indications as to how we might work with any current issues you may be experiencing.  Patient Health History is required for age twelve or above. Please print the agreements below and allow us to provide the best service and best results in the shortest amount of time.

 

INSTRUCTIONS 

  • Click on the forms you need, print and complete the requested information.

  • If possible, please fax, mail, or drop off your forms to our office prior to your appointment; if not, please arrive 15 minutes before your scheduled appointment with your paperwork completely filled out.

  • Please do not email forms to our office.

  • Our forms are in PDF format. You can download the Free AdobeReader here.

At the bottom of the patient health history, there is section labeled "MY PRIVACY". The signature is a confirmation that you've read/received a copy of the Notice of Privacy Practices, which is linked below.

Do you have Medicare?  Please read our letter to Medicare patients then print and fill out the Medicare Advance Notice Agreement.

Additional forms may be requested by your doctor or front staff.

Youth Patient History 

(Required for ages Birth to Twelve years)  

If your child is our patient, please complete and return one of the following forms to our office.

A Toddler and a Baby

Personal Injury Case
Workers' Compensation Case 

If you are seeing us under a Personal Injury or Workers' Compensation case, we will need the following information and forms:

Insurance Company Name

Insurance Representative Name and Phone Number

Address to Send Claims

Claim Number

Date of Accident/Injury